Plain-English overview
Medicaid is jointly funded by the federal government and states, but state Medicaid agencies make eligibility decisions and manage applications. Eligibility pathways vary based on age, pregnancy, disability, household, income, and state policy.
General eligibility considerations
These are common factors, not a personal eligibility decision:
- Most applicants are evaluated under an income methodology appropriate to their eligibility group.
- Residency, citizenship, or qualified immigration status rules apply.
- States may have different coverage pathways for children, pregnant people, adults, older adults, and people with disabilities.
Documents that may be requested
Requirements depend on the responsible agency. Common preparation items include:
- Identity and household information
- Social Security numbers when requested for applicants
- Income and tax-household information
- Current health coverage information
- Disability, pregnancy, or medical information when relevant to the eligibility pathway
How to get started
- Use Medicaid.gov to locate the official state Medicaid agency.
- Choose the state application, Marketplace application, phone, mail, or in-person method available to you.
- Answer household and income questions accurately for the requested coverage period.
- Upload or submit verification by the deadline.
- Read the eligibility notice and follow renewal or appeal instructions.
State and local variation
Income limits, covered groups, retroactive coverage, renewal procedures, and managed-care enrollment vary by state.
Limitations and cautions
Only the state agency can determine eligibility, effective dates, and coverage. Medical emergencies should not wait for an online eligibility guide.
Official starting resource
Continue with the responsible agency for current rules, applications, deadlines, and contact information.